Satisfaction assessment with malleable prosthetic implant of Spectra (AMS) and Genesis (Coloplast) models.

The malleable prosthetic implant is widely accepted among patients and physicians owing to a lower degree of surgical complexity, its rare mechanic failures and lower cost. We have compared the degree of satisfaction with malleable prosthetic implant in 60 patients, 36 with Spectra (AMS) and 24 with Genesis (Coloplast). For assessment purposes, we implemented the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) satisfaction questionnaire adapted for penile prosthetic implants. The mean age and follow-up was 61.7 years (31-82) and 19.9 months (1-61), respectively. Mean EDITS scores did not indicate superiority of one implant over the other, overall satisfaction index being 77.1% and 75.6% for Genesis and Spectra prosthesis, respectively (P=0.4970). Our results revealed that these two models of malleable prostheses present a high level of satisfaction and confirm that the malleable prosthetic implant is an excellent option to treat patients with ED refractory to medical treatment.

Morphological modifications in clitoris and vagina in spontaneously hypertensive rats.

We evaluated possible morphological alteration in clitoris and vagina from spontaneous hypertensive rats (SHR) and normotensive WKY rats. Clitoris and vagina were processed by Masson's trichrome, anti-alpha-smooth-muscle actin, anticollagen type I (COL I) and type III (COL III), and anti-TGFbeta(1). SHR presented higher amount of clitoral cavernous smooth muscle (CSM), vascular smooth muscle; TGFbeta(1) in clitoral vessel wall; higher wall/lumen ratio in both vaginal and clitoral vessels; and remarkable interstitial fibrosis, expressed by a higher amount in interstitial COL I and III in both clitoris and vagina, compared to WKY rats. Nerve fibers from clitoral and vaginal tissue in SHR showed important fibrosis at perineurium. SHR showed positive correlation between systolic blood pressure (SBP) and clitoral CSM; SBP and fibrosis in clitoris; and SBP and COL I and III in clitoris, respectively. Similar findings were observed between SBP and COL I and III in vagina. In conclusion, SHR present morphologic changes in clitoral vessels as well as in clitoral cavernous space, which have a high positive correlation with the high blood pressure level. Moreover, the increase in extracellular matrix affects not only the clitoral and vaginal interstitium but also the nerve structures from both clitoris and vagina.

Cathepsin B levels in urine from bladder cancer patients.

There is accumulating evidence that cysteine proteinase activity plays an important role in cancer cell invasion and metastasis. Previously we demonstrated that cathepsin B (CB) plasma activity is increased in patients with transitional bladder cancer (TCC). In this work we have attempted to determine whether urine CB protein levels could be used as tumor marker in bladder cancer patients. Urine CB levels were evaluated employing a dot blot method, in 30 patients with TCC, 21 patients successfully treated from TCC without evidence of disease at the moment of urine collection (NED) and in 30 healthy volunteers. The median value (Md) of the control group was 3.8 microg CB/ml. Significantly higher urine CB values (Md: 5.9 microg/ml) were found in the TCC group. A high CB value was also found in the NED group (5.0 microg/ml). Urine CB values over the 5.2 microg/ml (cut-off point) were observed in 63% of TCC patients, 48% of NED and 8% of the control group. Only 4% NED patients had CB values over 13.0 microg/ml while 33% of TCC patients surpassed this value. Thus, urine CB might be a potential marker for transitional bladder cancer diagnosis.

[Analysis of the results with Rigiscan in 93 impotent patients]. / Análisis de los resultados del Rigiscan en 93 pacientes con impotencia.

OBJECTIVE: This study was undertaken to evaluate the performance of the Rigiscan in the diagnosis of sexual impotence. METHODS: Erectile nocturnal activity was evaluated by Rigiscan in 93 patients consulting for impotence; mean age 56.8 years. Diagnosis and treatment were performed between October, 1990 and May, 1992. Follow up is currently ongoing. RESULTS: 95.1% of the patients with normal recordings had no organic pathology, and 80% of these recordings were observed on the first night of the study. In ruling out organic pathology, the Rigiscan did not have a higher specificity than the report of early morning erection (EME) by the patients (p > 0.05). Seventy three percent of the pathological results on the Rigiscan studies were associated to organic pathology. This test showed a higher sensitivity than the absence of EME (p < 0.01). Although no pathognomonic diagnostic pattern was found, a flat pattern and uncoupling were highly suggestive of organic disorders. CONCLUSIONS: The Rigiscan is a useful diagnostic tool, especially in patients reporting no EME. Furthermore, the Rigiscan was able to detect almost all the patients with organic pathology.

Hallazgos hitopatológicos del músculo cavernoso con microscopia óptica en hombres potentes e impotentes / Histopathological finding via optical microscopy in the cavernosum muscle of potent and impotent men

Nuestro propósito fue correlacionar los hallazgos hitopatológicos de muestras obtenidas del cuerpo cavernoso en 9 pacientes impotents que fueron sometidos a un implante protésico peneano, y 3 pacientes potentes intervenidos quirúrgicamente por estrechez uretral en 2 casos y por tumor de uretra en 1. Las muestra fueron coloreadas con hematoxilina-Eosina, Acido periódico de Shiff-Hematoxilina y Tricrómico de Masson para poder discriminar el tejido muscular del colágeno. Las trabéculasa musculares se hallaron alteradas en todos los pacientes impotentes estudiados, observándose un aumento relativo de la cantidad de tejido colágeno a expensas del tejido muscular. En 2 pacientes(22,2) la fibrosis no provocó la disrupción de los haces musculares (fibrosis discreta), y en los 7 restantes (77,7 por ciento) se halló disrupción y fragmnetación de los haces musculares (fibrosis moderada). Además, 5 de nuestro 6 pacientes diábeticos (83 por ciento), presentaron degeneración o desaparición de las vainas mielínicas de las fibras nerviosas. Nuestros próximos estudios mediante el análisis histomorfométrico computado, nos pemitirán incluir a la biopsi muscular cavernosa en el protocolo diagnóstico de pacientes con disfunción sexual aréctil que pudieran ser sometidos a cirugía de revascularización o por insuficiencia corporo-oclusiva

Hallazgos hitopatológicos del músculo cavernoso con microscopia óptica en hombres potentes e impotentes / Histopathological finding via optical microscopy in the cavernosum muscle of potent and impotent men

Nuestro propósito fue correlacionar los hallazgos hitopatológicos de muestras obtenidas del cuerpo cavernoso en 9 pacientes impotents que fueron sometidos a un implante protésico peneano, y 3 pacientes potentes intervenidos quirúrgicamente por estrechez uretral en 2 casos y por tumor de uretra en 1. Las muestra fueron coloreadas con hematoxilina-Eosina, Acido periódico de Shiff-Hematoxilina y Tricrómico de Masson para poder discriminar el tejido muscular del colágeno. Las trabéculasa musculares se hallaron alteradas en todos los pacientes impotentes estudiados, observándose un aumento relativo de la cantidad de tejido colágeno a expensas del tejido muscular. En 2 pacientes(22,2) la fibrosis no provocó la disrupción de los haces musculares (fibrosis discreta), y en los 7 restantes (77,7 por ciento) se halló disrupción y fragmnetación de los haces musculares (fibrosis moderada). Además, 5 de nuestro 6 pacientes diábeticos (83 por ciento), presentaron degeneración o desaparición de las vainas mielínicas de las fibras nerviosas. Nuestros próximos estudios mediante el análisis histomorfométrico computado, nos pemitirán incluir a la biopsi muscular cavernosa en el protocolo diagnóstico de pacientes con disfunción sexual aréctil que pudieran ser sometidos a cirugía de revascularización o por insuficiencia corporo-oclusiva(AU)

Melanoacantoma atipico localizado en piel de pene. / Atypical melanoacanthoma located in the base of the penis

Presentamos la observacion de un melanoacantoma atipico localizado en piel de raiz de pene en un paciente de 41 anos de edad.Se comenta la bibliografia de esta variedad de melanoma, de bajo grado de malignidad surgido de un acantoma. Consideramos de interes reportar a este paciente por la rareza de la afeccion en si y su localizacion inusual

Melanoacantoma atipico localizado en piel de pene. / Atypical melanoacanthoma located in the base of the penis

Presentamos la observacion de un melanoacantoma atipico localizado en piel de raiz de pene en un paciente de 41 anos de edad.Se comenta la bibliografia de esta variedad de melanoma, de bajo grado de malignidad surgido de un acantoma. Consideramos de interes reportar a este paciente por la rareza de la afeccion en si y su localizacion inusual

Systemic IFN-alpha treatment of multiple bladder papilloma grade I or II patients: pilot study.

Bladder papillomatosis offers a good target to evaluate IFN-alpha systemic treatment. We carried out a pilot study on eight multiple bladder papilloma patients under the same treatment scheme (1 x 10(6) IU/amp. every 48 h over six months), and they were followed-up for over two years after treatment. Recurrent patients underwent a similar second treatment. IFN-alpha therapy showed the following variations of effects: total disappearance, size decrease or persistence of papillomas, neither size increase nor appearance of new ones, remarkable valuable recurrence frequency rate decrease in all cases, and recurrences with smaller papillomas. This IFN-alpha treatment scheme would be fit to carry out broader controlled studies to show frequencies of the different kinds of responses. The inclusion of a minimum (dose-frequency-period) IFN-alpha treatment period after the first six months' therapy is proposed in order to achieve total disappearance of recurrences.